When paired with the right third party administrator (TPA) and program partners, self-funded plans can achieve big savings with their ability to accentuate population health management (PHM) – while still following strict measures to protect participant privacy. Kevin Schlotman of Benovation explains three areas to focus on and how engagement and incentive strategies factor into reduced claim costs. He shows how TPAs can identify a plan’s most costly chronic conditions, its patients at risk for adverse drug-to-drug reactions and the participants who may require help in managing their chronic conditions. On top of that, he shares how engaging with these groups and giving them reason to participate can really pay off in the long run. See how PHM contributes to self-funding success in Schlotman’s article (follow link below).
Follow-Up Comments from Kevin Schlotman: Some readers have expressed concern regarding the privacy of employees and family members when a Plan Sponsor engages in a Population Health Management program – and it’s a justifiable question. While unmentioned in my original article, it should be noted that a properly designed and implemented PHM program actively protects the information and privacy of all Plan enrollees. Plan Sponsors receive only aggregated reports across their Plan, not individual diagnoses by member. Any incentive reporting only notes whether or not a member has chosen to engage, not why that member was identified as a prospective candidate for coaching, education or support.
Certainly, there are those that wish to opt out of any PHM program. Some will voice their concerns, and others will object silently by simply not participating. Frequently, though, PHM programs generate “Thank You” comments after a year of operation – Plan members often tell our team that they appreciate the extra time, attention, and support provided by the program. They tell us that they never really understood why they should “follow Doctors Orders” or continue taking medications whose side effects they’d rather avoid. Coaches are often told by members that their Doctor never took the time (or didn’t have the time) to fully explain the “why” of their instructions, and what might happen if they didn’t do what they were asked to do. A little education goes a long way to bringing these patients into compliance with their physician’s recommendations.
Link to full article: Realizing the Payoffs through Population Health Management (PHM)
For more information or to contact Benovation, visit www.my-benovation.com or call (513) 872-7505.